GrumbleSmiles

For earlier stories on this subject, click on   “PRINCETHORPE COURT STORY”   in the TAG CLOUD.

Now we come to the final and most important chapter of the story.   All the effort, time and money would count for nothing if we had not achieved  “Better Lives for Older People”.

Anne Miller bought into the concept of promoting residents’ independence and choice completely.   In no time at all she involved them in all decisions about how Princethorpe Court was managed.

The Residents

Princethorpe Court was designed with activity in mind, so the communal areas were a platform for enhancing your lifestyle.

The restaurant was not a fast food outlet, it was a place you could come each day and socialise.   Everyone had a kitchen in their flat where they or the staff could prepare breakfast or tea, but lunchtime was a popular ‘communal event’ with the majority of residents.  Couples tended to be more self-sufficient, but the majority of residents lived on their own, so lunch was an opportunity for a natter.

There was a hairdressing room which was another popular place for a chat and a sure way of looking your best and lifting your spirits.  The communal laundry was another good place for catching up on all the latest gossip.

Dotted around the scheme, one in each street, were four small sitting rooms.   With Anne Miller’s encouragement, these were taken over by the residents and gradually established their own individual identity.   One as a library full of donated books and jigsaws, one was a spiritual room for quiet contemplation.  Others were used for knitting,   card making,   darts,   quizzes,   poetry reading,   costume making,   exercise  — the list became endless.   Many of these activities were organised and run by the residents themselves.

Anne saw every resident as a potential volunteer.   It was her way of ensuring everyone’s talents and abilities were recognised and utilised for the communal benefit.   After our initial concern about the size of the scheme, we often continued to discuss whether the scheme was too big – there were 48 flats but around 60 residents altogether.  The Social Service view was that anything over 35 flats would become institutional.   Anne’s perspective was that as long as each resident had a ‘role’, they would not get ‘lost’ in the size of the scheme.   Her idea of a ‘role’ was beyond any formal definition of a volunteer — Nora was a very quiet lady who liked to stay in her flat most of the time and just look out of her lounge window, which overlooked the car park — she always knew who had visited the scheme each day and became the scheme’s self-appointed security guard.

The residents at Princethorpe Court would not mind me saying they were “unremarkable”, they were no different to the residents in any of our later extracare schemes.   They had the usual range of frailties that you would expect in an age group that ranged from 60 to 100.  Their average age was late 70’s.   Most were women (80%), mostly widowed before they moved in, almost all came from the local area.   About a quarter had mobility issues and used a wheelchair.

At the same time, the staff ensured that all the residents were treated as individuals, and as their life stories and accomplishments became known, they were made to feel unique.   In that sense they were all “remarkable”.

Here are four people just to illustrate the point:-

TOM was a quiet man, a keen gardener.   He took over the extensive greenhouse and grew salad crops for the restaurant.   His tomatoes were his pride and joy.   Over the years he won medals and certificates galore.   A glass cabinet in the entrance hall of the scheme houses a big silver cup which was awarded to Princethorpe Court at ExtraCare’s first “Garden in Bloom” competition.   In the years to follow we realised that rewarding outstanding talent with small prizes was a way of reinforcing the message that residents had great skill and could still achieve a lot in later life.

JACK AND MABEL looked life in the face and overcame any difficulties they had with a smile.   At well over 70, they regularly flew to Canada to visit their children and grandchildren.   They were the life and soul of any party, in fact I first met Jack when he was bashing himself over the head with a tin tray and singing an old music hall song.   Playing the spoons was another favourite of his.

Jack fell in the empty bath overnight when he had got out of bed to go to the toilet.  He couldn’t get back out and Mabel could not hear him shouting for help, so he spent the rest of the night sleeping in the bath.  Then he got a lecture from Mabel in the morning for being so clumsy.  By the way, Jack had a tin leg, which he wasn’t wearing at the time.

In fact it was his tin leg that brought them together.   In Coventry during the war, they were both running to get into an air raid shelter.   Jack was slow because of his tin leg and when he got to the top of the stairs down into the shelter, he tripped and tumbled down the steps and landed on Mabel.   That’s how they first met – they were married for over fifty years – so Jack said he must have fallen for Mabel in a big way !

JOY KING moved into Princethorpe Court when it opened and still lives there today – over 20 years later.   I first met Joy when we played in a Christmas pantomime together.   She was the Fairy Queen — I think I was the bad guy.   I later found that Joy had come from a theatrical background.   Her father ran a travelling repertory theatre and Joy had to look after her baby sister while her mother and father were performing twice a day in plays.   They lived an itinerant life moving from one theatrical digs to another.   It was a hard life and Joy had a poor education because they never were in one school for more than a few weeks.

Joy joined in all the activities at Princethorpe and one of her proudest days was when she was awarded a degree from the University of ExtraCare for having completed a computer course.

There are hundreds of stories like these which just goes to show that  “Everyone has a Story to Tell”.   This was the title of a book we published to celebrate the lives of our residents after the first five years of ExtraCare.

The hard evidence to show that this model works is only becoming clear nearly 30 years after Princethorpe Court was conceived :-

• Residents who move into residential care on average only live four more years – in ExtraCare housing the average length of stay is 14 years.
• The average age of ExtraCare residents is between 75 and 80.  When asked how old they feel, most residents say they feel between 10 and 20 years younger than they actually are.

For earlier stories on this subject, click on   “PRINCETHORPE COURT STORY”   in the TAG CLOUD.

The Staff Support Team

From the very outset of developing our new concept, it was not just about bricks and mortar, it was about creating a more fulfilling life for residents.   A life that was able to reach beyond the tasks of daily living  and lift residents above their concerns about increasing frailty.   That said, it was also about maintaining and promoting their independence, by empowering them to build on their valuable skills and considerable life experience.

In other housing and care models, the care element creates dependence and communal living can reinforce the negative images of getting old.   We wanted to reverse that thinking and create positive opportunities for ageing, with support to overcome increasing frailty.

To do this we needed a special staff team, who aspired to do much more than offer comfort and care.   Our first Princethorpe Court Manager was an inspired and inspirational appointment.   Sister Anne Miller was a Franciscan Nun ,with a background of working in the third world.   She did not have the obvious recent experience in care management, we had set out to look for.   I was one of the interview panel and I have to admit before I met her I was very apprehensive.   My Welsh Chapel upbringing made me very nervous about having an overly pious scheme.   I think I expected Anne to come to the interview in a habit and be rather timorous.   I could not have been more wrong.  There was no habit, just a cross on a necklace and timid she was not !   She was very self-assured.   Obviously compassionate about the elderly and quite a feisty lady.   She even argued with me, which was a dangerous step in a job interview, but her conviction ( not the CRB type 🙂 ) made a lasting impression on me.   I still was not 100% sure, but Liz Taylor argued very strongly in favour of Anne, and that swung the day.

We never had reason to regret the decision.  Anne proved to be an exceptional manager who helped improve our vision beyond measure.   She built a strong staff team around her and helped them to understand the difference between the care background most of them had come from, and the supportive environment we wished to create.   We didn’t rush in and do things for people, we wanted to help and encourage them to do things for themselves.   It is about restoring confidence to people.   This takes time and patience, which can easily be squeezed out of a hard pressed staff schedule.   The result is that care hastily delivered can often lead to greater dependency.   This lesson has certainly been lost in the modern-day express style speedy boarding NHS.   It was also seldom seen in minimum staff levelled residential care, where high staff turnover and frequent use of agency staff meant there was little time to really get to know residents’ individual needs.

At Princethorpe Court, Anne’s team developed support plans which embraced the whole of a residents’ life, not just their immediate care needs.   Later this became known as a “Book of Life” and was a written and photographic record of a resident’s past life and future ambitions.

It was testament to Anne Miller’s mentoring skills that her two senior staff, Mary Saint and Ginny Larkin, both went on to become managers of their own schemes in the ExtraCare Charitable Trust.   Many other staff also were promoted to managerial and team leader positions in the following years and transferred the Princethorpe culture to other schemes.

MORE TO COME

For earlier stories on this subject, look up “PRINCETHORPE COURT STORY” in the TAG CLOUD.

The Design

This section is not intended to be a design brief, I just want to illustrate how the concept we were developing permeated through the whole of the design, right down to the smallest detail.  We also wanted to get well away from the institutional feel of residential care which emphasised to residents they were living in someone else’s building, which was no longer their own home.

We were wanting to create an environment where people could live out the rest of their lives and not have to move on.  We also wanted it to be a community where you could enjoy the privacy of your own home but have the company and support of the neighbours around you.

The scheme had 48 flats which was considered large. at a time when 30-35 dwellings was more the norm.  The reason for the bigger project was related to the need for scale to support a care staff team and a restaurant.  The flats themselves were mainly one bedroom, but we insisted on them being 2-person i.e. big enough for a double bed.  This is a forgotten issue these days but one bed, one person was the standard at the time.  The flats were only 35m² which is very small compared to the 50m plus of the current day.  The Princethorpe flats were palaces compared to a 10m² bedroom in residential care!

A key principle was that there was level access throughout the scheme – lifts were provided to the first floor and their were no steps or stairs anywhere in the scheme ( except for fire escape stairs ) — all doors were extra wide to accommodate wheelchairs and fire doors were free-swing or held back on magnetic links and only closed automatically if there was a fire alarm.  These issues are standard today, but at the time they were exceptional and relatively expensive to provide.

Now let’s look at some of the more symbolic details in the scheme which were designed to emphasise the concept:-

• Individual House Front Doors.

Front doors to flats in residential care and in a lot of Local Authority / Housing Association sheltered housing were generally flush style internal doors, often all gloss painted the same colour to minimise initial and future maintenance costs.  At Princethorpe Court we took the opposite view.  Your front door is a symbol of your home as your castle.  Front doors were panelled external doors with brass door knockers, brass house numbers and letter boxes.  The knocker said to staff, knock and wait before you enter someone’s home – this often was not the practice in residential care.

The letter box was even more contentious, with the fire officer and the Post Office.  Fire officers didn’t want a hole in a fire door, and this debate lasted until we found a compromise, but we kept the letter boxes!  The Post Office just did not want the hassle of delivering post within the scheme, when in a residential care home they could do one delivery to the manager’s office.  This argument raged for many months, but we were adamant that residents had their own address and were entitled to receive their mail through their own individual letter box.  We won in the end but there were some grumpy postmen to start with.

Once we had the letter box, we could also have newspapers delivered and leave people to pay their own bills, which underlined the concept of people living independently in their own homes.

This idea extended to milk deliveries and a shelf was provided outside each front door.

• Internal Streets.

The internal corridors of most residential care homes were long, straight, bare-walled   and only punctuated by regularly spaced identical front doors.   Small filing cabinet labels were the only way of knowing somebody lived inside the flats.  The easy slip-in and out label was an indication of how long they were expected to stay.

We were building homes for people to live long happy lives and we wanted them to be proud of their new homes.

At this point I must mention the designer of Princethorpe Court.  Ian Hardy was an exceptionally talented architect and he bought into the concept completely.  He also took us literally when we said we wanted an excellent design and that’s what he gave us – but it wasn’t cheap.  Still he gave us design ideas which ExtraCare Charitable Trust is still using to this day.

In the internal corridors, Ian styled them as external streets.  The flats all had kitchen windows looking onto the street.  The walls were constructed with an expensive external rustic brindle brick that matched the outside of the scheme.  External wall lamps illuminated the corridors focussed around the porch of the flats’ front doors.  The corridor floor was a jute matting which was imported from Holland.  It was not only expensive, but we were worried about its durability.  Thirty years later, it is still there and looking good.  The widths of the corridors were relatively wide and at corners were opened out to include planting boxes full of rubber plants, ferns and assorted jungle vegetation.

To finally seal the idea that this was more like an external environment, the first residents to move in were invited to give each corridor a separate “street” name which then became part of their address.

These are only two examples of the many issues we debated over long hours – developing the concept.  We were fortunate to have Ian Hardy’s design flare to interpret them so well.  It is testament to the whole team that many of these themes continue to be used to this day.

MORE TO COME